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Study examines association of smoking with hemorrhage after throat surgery
August 19, 2008Smoking appears to be associated with an increased rate of hemorrhage (bleeding) in patients who undergo uvulopalatopharyngoplasty (UPPP, a surgical procedure used to remove excess tissue from the throat) with tonsillectomy (a surgical procedure in which the tonsils are removed), but not in those who undergo tonsillectomy alone, according to a report in the August issue of Archives of Otolaryngology−Head & Neck Surgery, one of the JAMA/Archives journals.
Although indications for tonsillectomy have changed over the years, it remains a common surgical procedure with a substantial risk for complications, the greatest of which is post-operative hemorrhage, according to background information in the article.
Sean M. Demars, M.D., then of Madigan Army Medical Center, Tacoma, Wash., and now of Bassett Army Community Hospital, Fort Wainwright, Alaska, and colleagues evaluated the rate of post-operative bleeding in 1,010 tonsillectomy patients from 2000 to 2005. Age, sex and smoking status were also noted.
The total bleeding rate for all patients was 6.7 percent. When divided into smokers and non-smokers, the bleeding rate for patients was 10.2 percent and 5.4 percent, respectively. The large difference was found "to be attributable to a marked increase in post-operative hemorrhage in the patients who underwent UPPP [10.9 percent in smokers vs. 3.3 percent in non-smokers]," the authors write. In addition, "men who underwent tonsillectomy alone bled significantly more than women (11.2 percent and 5.4 percent, respectively)."
Awareness of the association between smoking and post-operative hemorrhage "may help clinicians further counsel their patients before surgery," the authors conclude. "Further investigation of this relationship is needed, with stratification of patients by the number of cigarettes smoked and attention to the length of time before and/or after surgery that patients refrain from smoking."
JAMA and Archives Journals
The total bleeding rate for all patients was 6.7 percent. When divided into smokers and non-smokers, the bleeding rate for patients was 10.2 percent and 5.4 percent, respectively. The large difference was found "to be attributable to a marked increase in post-operative hemorrhage in the patients who underwent UPPP [10.9 percent in smokers vs. 3.3 percent in non-smokers]," the authors write. In addition, "men who underwent tonsillectomy alone bled significantly more than women (11.2 percent and 5.4 percent, respectively)."
Awareness of the association between smoking and post-operative hemorrhage "may help clinicians further counsel their patients before surgery," the authors conclude. "Further investigation of this relationship is needed, with stratification of patients by the number of cigarettes smoked and attention to the length of time before and/or after surgery that patients refrain from smoking."
JAMA and Archives Journals
Tonsillectomy Current Events and Tonsillectomy News RSSMysterious fevers of unknown origin: could surgery be a cure?
A child spikes a high fever, sometimes as high as 104 or 105 degrees, and sometimes causing seizures. She's rushed to the emergency room, the hospital runs test after test, specialists are brought in, but no explanation is found.
Surgery Improves Quality of Life for Children with Sleep Apnea, SLU Study Finds
For children who suffer from obstructive sleep apnea (OSA), a tonsillectomy and adenoidectomy can provide dramatic relief and is successful in solving sleep problems for 80 to 90 percent of children, a Saint Louis University study found.
Tonsillectomy significantly improves quality of life in adult and pediatric patients
Tonsillectomies to treat chronic and recurrent tonsillitis substantially improve a patient's quality of live in both children and adults, according to two new studies published as a supplement to the January 2008 issue of Otolaryngology-Head and Neck Surgery.
Robotic device appears useful for surgical removal of cancer involving the tonsils
A new robotic surgery technique appears promising for the removal of cancer involving the tonsil region, according to a report in the December issue of Archives of Otolaryngology-Head & Neck Surgery, one of the JAMA/Archives journals.
Certain tonsil removal technique associated with reduced postoperative pain, bleeding
Patients who have a tonsillectomy using an "intracapsular" technique-which removes at least 90 percent of tonsil tissue, but spares the tonsil capsule-appear to have less postoperative heavy bleeding and pain compared with those who undergo traditional tonsil removal surgery.
Study shows no change in sense of taste after tonsil removal
In a small study of patients undergoing tonsillectomy, or removal of the tonsils, none reported an ongoing dysfunction in their sense of taste following the procedure.
Is it worth having surgery to remove your tonsils?
Adults with recurrent sore throats may benefit from having a tonsillectomy in the short term, but the overall longer term benefit is still unclear, and any benefits have to be balanced against the side effects of the operation, according to this week's BMJ.
Sleep problems in overweight children appear fairly common
One-fourth of overweight children may have sleep problems that regular physical activity can largely resolve, researchers say.
Shorter post-operative recovery stay following outpatient tonsillectomy is safe, cost-efficient
Children undergoing tonsillectomies will be happy to know they should be able to go home shortly after surgery. A new UCLA study showed that it can be safe and cost-efficient to discharge pediatric tonsillectomy patients after a short post-operative recovery period at an outpatient surgery center.
Intact tonsils triple risk of recurrent strep throat
Children with recurrent strep throat whose tonsils have not been removed are over three times more likely to develop subsequent episodes of strep throat than children who undergo tonsillectomy.
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